Latent autoimmune diabetes in adults (LADA)

master's thesis

• Title (croatian): Latentni autoimunosni dijabetes odraslih
• Author: Allan Gutlić
• Mentor: Ivana Pavlić-Renar (mentor)
• Committee member: Ivana Pavlić-Renar (predsjednik povjerenstva)
• Committee member: Tina Dušek (član povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2017-07-14, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Latent autoimmune diabetes in adults (LADA) is a form of diabetes with a wide range of phenotypic presentations. This review focuses on the best diagnostic method based on current studies and examines the best treatment approach once diagnosis has been made in patients with LADA. Based on glutamic acid decarboxylase autoantibody (GADA) titers it can be divided into either LADA 1 or LADA 2. The former sharing clinical features of DM 1 with quicker onset of insulin dependence, the latter resembling DM 2 with higher BMI and less need for insulin. The clinical and genetic heterogenuity of LADA has caused much controversy as it has been debated whether or not it should be considered as a separate entity or part of a continuum between DM 1 and DM 2. However, proper diagnosis and treatment are highly needed for this subgroup of patients, as they eventually have worse metabolic control and are more prone to DKA than DM 2 patients. The proportion of patients with LADA and DM 1 is roughly estimated to be equal, considering the fact that about 10 % of DM 2 patients actually belong to the LADA subgroup. With regards to this large number of LADA patients, screening methods are crucial for indentification, correct treatment and stricter metabolic control.

Abstract (croatian)

Latentni autoimunosni dijabetes odraslih (LADA - akronim po engleskom nazivu) je oblik šećerne bolesti širokog spektra fenotipa. Ovaj prikaz je usredotočen na metode dijagnoze temeljene na ispitivanjima i na terapijski pristup kada se dijagnoza postavi. Temeljem titra antitijela na dekarboksilazu glutaminske kiseline (GADA) može se podijeliti u LADA 1 i LADA 2. LADA 1 je sličan tipu 1 šećerne bolesti s bržim nastankom ovisnosti o inzulinu dok LADA 2 klinički više liči na tip 2 uz veći indeks tjelesne mase i s manjom potrebom za inzulinom. Klinička i genetska heterogenost LADA izaziva dosta kontroverzi. Raspravlja se jesu li to različiti entiteti ili se radi o kontinuumu između tipa 1 i tipa 2 šećerne bolesti. U svakom slučaju, prava dijagnoza je nužna za ovu skupinu bolesnika jer oni postaju metabolički loše regulirani i skloniji su ketocidozi od onih s tipom 2 bolesti. Udio bolesnika s LADA i tipom 1 se procjenjuje ugrubo istim zbog činjenice da je oko 10 % osoba s tipom 2 šećerne bolesti u ovoj podskupini. Obzirom na velik broj osoba s LADA dijagnostičke metode su bitne za njihovu identifikaciju koja omogućuje prikladnije liječenje i striktniju metaboličku kontrolu.

• Keywords: LADA; autoimmune; diabetes; GADA; diagnostic criteria
• Keywords (croatian): LADA; autoimunost; šećerna bolest; GADA; dijagnostički kriteriji
• Language: english
• URN:NBN: urn:nbn:hr:105:496978
• Study programme: Title: Medicine (in English language); Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2018-04-18 09:56:23